DESTINATION is a novel and exciting feasibility study of dose de-escalation in prostate radiotherapy. It is now open to recruitment with patients having been treated at all three participating centres: Royal Marsden Hospital (RMH), Sunnybrook Health Sciences Centre and Netherlands Cancer Institute (NKI).
In DESTINATION men with intermediate-risk prostate cancer will receive 30 Gy in 5 fractions with a boost to the dominant lesion of 45 Gy. Treatment is delivered on the Unity MRL using MRI-guided adaptive radiotherapy with the aim of curing prostate cancer whilst limiting toxicity. Treatment so far has been well tolerated and we hope to show feasibility whilst maximising quality of life in this cohort of men with good cancer outcomes. If feasibility is shown, then we will graduate to a larger randomised control trial, comparing dose de-escalation to non-dose de-escalated SBRT on the MRL.